Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan
Abstract Background Insulin resistance (IR) plays a crucial role in the occurrence and progression of diabetes. This study aimed to evaluate and compare the predictive value of four IR surrogates, including the triglycerides glucose (TyG) index, TyG and body mass index (TyG-BMI), triglycerides/high-...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-024-01307-x |
| _version_ | 1797259144907980800 |
|---|---|
| author | Qing Shangguan Qiuling Liu Ruijuan Yang Shuhua Zhang Guotai Sheng Maobin Kuang Yang Zou |
| author_facet | Qing Shangguan Qiuling Liu Ruijuan Yang Shuhua Zhang Guotai Sheng Maobin Kuang Yang Zou |
| author_sort | Qing Shangguan |
| collection | DOAJ |
| description | Abstract Background Insulin resistance (IR) plays a crucial role in the occurrence and progression of diabetes. This study aimed to evaluate and compare the predictive value of four IR surrogates, including the triglycerides glucose (TyG) index, TyG and body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (MetS-IR) for diabetes in two large cohorts. Methods A total of 116,661 adult participants from the China Rich Healthcare Group and 15,464 adult participants from the Japanese NAGALA cohort were included in the study. Multivariable Cox proportional hazards models were used to assess the standardized hazard ratio (HR) of the TyG index, TyG-BMI, TG/HDL-C ratio, and MetS-IR directly associated with diabetes. Receiver operating characteristic (ROC) curve and time-dependent ROC curve analysis were performed to evaluate and compare the predictive value of the four IR surrogates for diabetes. Results In the two independent cohorts, the average follow-up time was 3.1 years in the China cohort, with 2681(2.30%) incident cases of diabetes recorded, and 6.13 years in the Japan cohort, with 373 incident cases (2.41%) of diabetes recorded. After adjusting for potential confounding factors, we found that among the four IR surrogates, TyG-BMI and MetS-IR showed stronger associations with diabetes. The stronger associations persisted even after further stratification by age, sex, hypertension, and obese subgroups. In terms of diabetes prediction, based on ROC analysis, TyG-BMI demonstrated the highest predictive accuracy for diabetes in the Chinese population, while both TyG-BMI and MetS-IR showed the highest predictive accuracy in the Japanese population. The results of further subgroup ROC analysis confirmed the robustness of these findings. Furthermore, the time-dependent ROC results indicated that among the four IR surrogates, MetS-IR exhibited the highest accuracy in predicting future diabetes at various time intervals in the Japanese population. Conclusion Our findings suggest that evaluating TyG-BMI and MetS-IR as IR surrogates may be the most useful for predicting diabetes events and assessing the risk of developing diabetes in East Asian populations. |
| first_indexed | 2024-04-24T23:04:46Z |
| format | Article |
| id | doaj.art-54e0687ce959423bbcea6827c653f1a9 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-24T23:04:46Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-54e0687ce959423bbcea6827c653f1a92024-03-17T12:33:35ZengBMCDiabetology & Metabolic Syndrome1758-59962024-03-0116111410.1186/s13098-024-01307-xPredictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and JapanQing Shangguan0Qiuling Liu1Ruijuan Yang2Shuhua Zhang3Guotai Sheng4Maobin Kuang5Yang Zou6Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeCardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeJiangxi Medical College, Nanchang UniversityCardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeCardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeAbstract Background Insulin resistance (IR) plays a crucial role in the occurrence and progression of diabetes. This study aimed to evaluate and compare the predictive value of four IR surrogates, including the triglycerides glucose (TyG) index, TyG and body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (MetS-IR) for diabetes in two large cohorts. Methods A total of 116,661 adult participants from the China Rich Healthcare Group and 15,464 adult participants from the Japanese NAGALA cohort were included in the study. Multivariable Cox proportional hazards models were used to assess the standardized hazard ratio (HR) of the TyG index, TyG-BMI, TG/HDL-C ratio, and MetS-IR directly associated with diabetes. Receiver operating characteristic (ROC) curve and time-dependent ROC curve analysis were performed to evaluate and compare the predictive value of the four IR surrogates for diabetes. Results In the two independent cohorts, the average follow-up time was 3.1 years in the China cohort, with 2681(2.30%) incident cases of diabetes recorded, and 6.13 years in the Japan cohort, with 373 incident cases (2.41%) of diabetes recorded. After adjusting for potential confounding factors, we found that among the four IR surrogates, TyG-BMI and MetS-IR showed stronger associations with diabetes. The stronger associations persisted even after further stratification by age, sex, hypertension, and obese subgroups. In terms of diabetes prediction, based on ROC analysis, TyG-BMI demonstrated the highest predictive accuracy for diabetes in the Chinese population, while both TyG-BMI and MetS-IR showed the highest predictive accuracy in the Japanese population. The results of further subgroup ROC analysis confirmed the robustness of these findings. Furthermore, the time-dependent ROC results indicated that among the four IR surrogates, MetS-IR exhibited the highest accuracy in predicting future diabetes at various time intervals in the Japanese population. Conclusion Our findings suggest that evaluating TyG-BMI and MetS-IR as IR surrogates may be the most useful for predicting diabetes events and assessing the risk of developing diabetes in East Asian populations.https://doi.org/10.1186/s13098-024-01307-xInsulin resistance surrogatesDiabetesIR surrogatesTriglycerides glucose indexTyG-BMITG/HDL-C ratio |
| spellingShingle | Qing Shangguan Qiuling Liu Ruijuan Yang Shuhua Zhang Guotai Sheng Maobin Kuang Yang Zou Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan Diabetology & Metabolic Syndrome Insulin resistance surrogates Diabetes IR surrogates Triglycerides glucose index TyG-BMI TG/HDL-C ratio |
| title | Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan |
| title_full | Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan |
| title_fullStr | Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan |
| title_full_unstemmed | Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan |
| title_short | Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan |
| title_sort | predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia findings from two independent cohort studies in china and japan |
| topic | Insulin resistance surrogates Diabetes IR surrogates Triglycerides glucose index TyG-BMI TG/HDL-C ratio |
| url | https://doi.org/10.1186/s13098-024-01307-x |
| work_keys_str_mv | AT qingshangguan predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT qiulingliu predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT ruijuanyang predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT shuhuazhang predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT guotaisheng predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT maobinkuang predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan AT yangzou predictivevalueofinsulinresistancesurrogatesforthedevelopmentofdiabetesinindividualswithbaselinenormoglycemiafindingsfromtwoindependentcohortstudiesinchinaandjapan |